Phase I trial to study the effectiveness of radiolabeled monoclonal antibody therapy with or without peripheral stem cell transplantation in treating patients who have recurrent or refractory lymphoma. Radiolabeled monoclonal antibodies can locate cancer cells and deliver radioactive tumor-killing substances to them without harming normal cells. Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by anticancer therapy

Patients receive rituximab IV over 4-6 hours followed by IDEC-In2B8 IV over 10 minutes on day 0 and undergo whole body imaging. Patients may then receive rituximab IV over 4-6 hours followed by IDEC-Y2B8 IV over 10 minutes on day 7.

Some patients receive autologous PBSC IV over 30-60 minutes on day 35.

Biological: rituximab

Given IV

Other Names:

IDEC-C2B8

IDEC-C2B8 monoclonal antibody

Mabthera

MOAB IDEC-C2B8

Rituxan

Radiation: indium In 111 ibritumomab tiuxetan

Given IV

Other Name: IDEC-In2B8

Radiation: yttrium Y 90 ibritumomab tiuxetan

Given IV

Other Names:

90Y ibritumomab tiuxetan

IDEC Y2B8

Y90 Zevalin

Y90-labeled ibritumomab tiuxetan

Procedure: peripheral blood stem cell transplantation

Undergo PBSC transplantation

Other Names:

PBPC transplantation

PBSC transplantation

peripheral blood progenitor cell transplantation

transplantation, peripheral blood stem cell

Other: laboratory biomarker analysis

Correlative studies

Experimental: Group B (planned PBSC support)

Patients receive rituximab, IDEC-In2B8, and IDEC-Y2B8 as in group A. Patients also receive autologous PBSC IV over 30-60 minutes on day 21 and G-CSF subcutaneously beginning on day 22 and continuing until blood counts recover or day 35.

Biological: rituximab

Given IV

Other Names:

IDEC-C2B8

IDEC-C2B8 monoclonal antibody

Mabthera

MOAB IDEC-C2B8

Rituxan

Radiation: indium In 111 ibritumomab tiuxetan

Given IV

Other Name: IDEC-In2B8

Radiation: yttrium Y 90 ibritumomab tiuxetan

Given IV

Other Names:

90Y ibritumomab tiuxetan

IDEC Y2B8

Y90 Zevalin

Y90-labeled ibritumomab tiuxetan

Procedure: peripheral blood stem cell transplantation

Undergo PBSC transplantation

Other Names:

PBPC transplantation

PBSC transplantation

peripheral blood progenitor cell transplantation

transplantation, peripheral blood stem cell

Biological: filgrastim

Given subcutaneously

Other Names:

G-CSF

Neupogen

Other: laboratory biomarker analysis

Correlative studies

Detailed Description:

OBJECTIVES:

I. Determine the maximum tolerated dose (MTD) of yttrium Y 90 ibritumomab tiuxetan (IDEC-Y2B8) when preceded by rituximab in children with recurrent or refractory CD20-positive lymphoma for which no autologous peripheral blood stem cell transplantation (AuPBSCT) is planned. (Group A) If the dose-limiting toxicity (DLT) in group A is purely hematological, determine the MTD of IDEC-Y2B8 when combined with rituximab, AuPBSCT, and filgrastim (G-CSF) in a second group of children with recurrent or refractory CD20-positive lymphoma. (Group B) II. Determine the DLT of rituximab and IDEC-Y2B8 in these patients. III. Determine the dosimetry of indium In 111 ibritumomab tiuxetan preceded by rituximab in these patients.

IV. Determine, preliminarily, the antitumor activity of rituximab and IDEC-Y2B8 in these patients.

V. Assess the immune cell depletion (B-cell and T-cell) and recovery in patients treated with this regimen.

VI. Determine the human anti-mouse antibody response in patients treated with this regimen.

OUTLINE: This is a multicenter, dose-escalation study of yttrium Y 90 ibritumomab tiuxetan (IDEC-Y2B8). Patients are assigned to 1 of 2 groups.

GROUP A (no planned peripheral blood stem cell [PBSC] support): Patients receive rituximab IV over 4-6 hours followed by indium In 111 ibritumomab tiuxetan (IDEC-In2B8) IV over 10 minutes on day 0 and undergo whole body imaging. Patients may then receive rituximab IV over 4-6 hours followed by IDEC-Y2B8 IV over 10 minutes on day 7.

Cohorts of 3-6 patients in each subgroup (A1, A2, and A3) receive escalating doses of IDEC-Y2B8 until the maximum tolerated dose (MTD) is determined (subgroup A1 closed as of 10/8/04). The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity (DLT).

Some patients receive autologous PBSC IV over 30-60 minutes on day 35.

GROUP B (planned PBSC support): Patients receive rituximab, IDEC-In2B8, and IDEC-Y2B8 as in group A. Patients also receive autologous PBSC IV over 30-60 minutes on day 21 and filgrastim (G-CSF) subcutaneously beginning on day 22 and continuing until blood counts recover or day 35.

If the DLT in group A is purely hematological, cohorts of 3-6 patients in group B receive escalating doses of IDEC-Y2B8 until the MTD is determined. The MTD is defined as in group A.

Patients in both groups are followed at days 63, 90, 180, 365, and then annually thereafter.

Eligibility

Ages Eligible for Study:

up to 21 Years

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria:

Histologically confirmed and immunophenotypically (CD20)-positive lymphoma at original diagnosis, progression, or relapse

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For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00036855